Summary:

Professor Sandra Bertman founded the Medical Humanities Program at the University of Massachusetts Medical Center and holds certificates in grief counseling and death education. This handbook outlines how she uses the visual and literary arts to "improve our professional abilities to deal with death and dying." Her premise is that the arts provide a valuable vehicle for exploring and making bearable the prospect and fact of death.

Bertman illustrates her presentation technique (Chapter 2) of juxtaposing dual images around six central themes, here abbreviated: the chosen death; death and afterlife; existential aloneness; loss of control, unmentionable feelings, grief; the land of the sick vs. the land of the well; the moment of death. The book offers dozens of paintings, sketches, and photographs (reproduced in black and white), as well as many literary excerpts. Classic works are represented (David's painting, The Death of Socrates; Michelangelo's sculpture, "Pieta"; Tolstoy's novel, The Death of Ivan Ilyich) but there are many unusual representations as well--greeting card messages, epitaphs, cartoons.

In addition, some groups with whom she works (for example, medical students studying Gross Anatomy) have submitted their own drawings and commentary. These are shown in Chapter 3, along with written responses to a follow-up Death Attitude Questionnaire. Responses are from junior and senior high school students; college students; medical students; graduate nurses; hospice volunteers.

Chapter 4 gives suggestions for how to use images and texts and for how to approach discussions of loss and grief. The course syllabus for "Dissection, Dying, and Death," taught with Gross Anatomy, is appended, and there is an extensive bibliography.

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In four lengthy chapters, the biographies of Haydn, Mozart, Beethoven, and Schubert are carefully presented. Special attention is given to health, both physical and psychological, throughout life and at its end. Autopsy information is included. In particular, the author emphasizes the impact of illness on the composers' relationships with family members and doctors, and on their musical composition.

Evidence is derived from a wealth of primary sources, often with long citations from letters, poetry, musical scores, prescriptions, diaries, the remarkable "chat books" of Beethoven. Neumayr also takes on the host of other medical biographers who have preceded him in trying to retrospectively 'diagnose' these immortal dead.

Late eighteenth- and early nineteenth-century Vienna emerges as a remarkable city of musical innovation and clinical medicine. The composers' encounters with each other link these biographies. Similarly, many patrons, be they aristocrats or physicians, appear in more than one chapter, such as the Esterhazy family and Dr Anton Mesmer.

The disease concepts of the era, prevalent infections, and preferred therapies are treated with respect. Rigid public health rules in Vienna concerning burial practices meant that ceremonies could not take place in cemeteries and may explain why some unusual information is available and why other seemingly simple facts are lost.

Biographical information about the treating physicians is also given, together with a bibliography of secondary sources, and an index of specific works of music cited.

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This beautifully illustrated (by Teddy Kristiansen) semi-autobiographical graphic novel captures the struggle of the author to take on the assignment as the newest chronicler of the adventures of Superman. This once-in-a lifetime opportunity evokes the memory of his first encounter with the man of steel--as a young boy reading his Superman comic book in a hospital waiting room as his grandmother lies dying of Huntington's disease.

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This film by Danish filmmakers focuses on two Scots, Wilbur (Jamie Sives) and his older, considerate brother Harbour (Adrian Rawlins), who own a family buy-and-sell bookshop, North Books, in Glasgow. The opening movie credits intersperse with Wilbur's suicide attempt by pills and gassing himself. Wilbur's attempt is thwarted first by the fact that he has to put more coins into the apartment gas meter, and then by his brother, whom Wilbur had telephoned just before losing consciousness. Wilbur continues suicide attempts throughout much of the movie, with methods that range from the absurd to the disturbingly tragic.

The brothers' father had recently died and several scenes occur at a hillside cemetery. Surrounded by imposing stone monuments, the brothers' parents are buried without markers, but with a view, if you cock your head and imagine, of the bookshop. The tragedy of the mother's death when Wilbur was only 5 years old, is invoked to explain much of Wilbur's disturbance.

Early in the movie, Alice (Shirley Henderson), a waif-like single mother who cleans the operating and trauma theatres and sells books she finds at the hospital to the bookshop, is introduced, along with her soon to be 9 year old daughter, Mary (Lisa McKinlay). Alice and Harbour wed, and Mary presciently plunks a penguin eraser she has just received atop the wedding cake next to the bride and groom: "That's Wilbur," she says.

Two hospital workers feature prominently in the film. Horst (Mads Mikkelsen) is a Danish ex-pat physician and "senior psychologist." He chain smokes, distances himself from the group therapy he supposedly supervises, and yet deftly discusses bad news with Harbour in several scenes. The psychiatric nurse, Moira (Julia Davis), however, who, with ever-changing hairstyles and inappropriate nurse-patient interactions, acts primarily as comic relief, delivers the same bad news with unthinking, devastating directness.

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It is 1820 and Cassie lives on a farm in Maine with her parents and three brothers. One of them, Will, damages his leg with an axe as he hears Cassie scream while he is chopping wood. The gangrene and days of near-death suffering that ensue eventuate in amputation of the leg. During this crisis Cassie is Will's primary caretaker, partly because she feels the accident was her fault.

Their father wants to let Will die, as he feels there will be no life for him as an amputee. But Will survives and he and Cassie go to live with an older married sister in town where Will finds he has talents and options that might never have occurred to him had he simply grown into the farming life he loved. The year following the accident in this way opens both Cassie's and Will's imaginations to other kinds of lives to be lived. For Cassie it awakens a longing to do medical work, as caring for Will has made her aware of the deep satisfactions of caregiving.

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Written while Carruth was approaching or had reached the age of 80 years, this collection understandably reflects the recognition of aging, loss, and of a changing world. Also, there are memories--of jazz and jazz players, relatives, pets, youth. And there is life in the present--with grown children, old friends, the Vermont countryside, writing, remembering, coping, not coping. Throughout, Carruth has a no-nonsense style; a mixture of straight talk, irony, irreverence, contemplation--and wonderful craft.

Carruth's adult daughter, Martha, died miserably of cancer in the late 1990s; in Part II, "Martha," Carruth describes himself as "blocked and almost silent / for two years. Titled "Dearest M --", this is a 15-page elegy that accomplishes "a release of some dire kind" (46) for Carruth, but he can't take pleasure in the release, feeling shame instead ("how shaming, how / offensive!"). Even in his mourning, Carruth raises questions about the ethics of writing such poems, and questions whom he is addressing ("not Martha. The absence / is like a hollow in my mind" [48]).

Section IV, "Faxes to William," is a series of 54 short poems addressed in "faxes" to a mysterious William: "William, do you know why / I like writing these faxes / to you? Because you / don't have a fax machine" (75). The poems instruct William about writing poetry ("some poets write blurbs, William, / and some do not. And it is by / a law of nature that the former / envy the latter desperately . . . They have unmade / their beds and they must schlepp in them" [67]); and life ("William, for the things / life didn't give us / we have no / compensation. None." [7]); and pose conversational questions ("You say I shouldn't write / so much about old age?) that have their own answers (I always / told my students to write / about what they know" [86]).

Section V, "Basho," is in dialogue with a 17th-century Japanese poet who is considered to be the best haiku poet during the time this form was being developed. Carruth's haiku-like poems in this section blend reflections on aging with reflections on writing poetry.

The final section, "Second Scrapbook," continues to explore memories ("Memory," in which Carruth learns of a former wife's death and can remember her--fondly--only as she was years ago. "My dear, / How could you have let this happen to you?" [116]); growing old ("Senility": "week after week, the mist gathering" [120]); representation ("Something for the Trade": Please note well, all you writers, editors, directors / out there: when a phone call is terminated / by the other person you do not, NOT, hear / a dial tone" [121]).

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The narrator of the story, a former district doctor in Russia, reminisces about his frequent encounters with patients suffering from secondary syphilis ("the speckled rash"). The first case he diagnoses is a 40-year-old man seeking treatment for a sore throat. The doctor recommends the application of a bagful of mercury ointment once a day and a follow-up visit after 6 days, but the man never returns. The physician advises him that his wife needs to be examined also, but she is never seen in the clinic.

The doctor remembers many other cases of secondary syphilis in the community. Except for one young woman, patients seem to have little fear of the disease. Children and even entire families are infected. The physician decides to tackle the widespread venereal disease and to confront the rampant patient apathy in the district.

His weapons include mercury ointment, potassium iodide, Salvarsan (an arsenic compound) injections, harsh words, and warnings about the horrible effects of the disease if left untreated. He opens an inpatient unit to treat patients with syphilis. Now long-removed from that remote medical outpost, the narrator still wonders about the people living there.

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When faced with breast cancer and chemotherapy, Catherine Lord chronicles her illness in a literary performance piece by adopting the online persona of Her Baldness--a testy, witty, passionate presence who speaks forthrightly about her fears to a highly selective listserv audience of friends, family, and colleagues. The fragmented, multifaceted format of this autobiographical text includes photos, lists, e-mail narrations of her illness, responses from friends, plus the quick-tempered, no-holds-barred ruminations of Her Baldness on what cancer, chemotherapy, and baldness have meant in her life.

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In the Foreword to this collection, poet John Graham-Pole writes, "Children have uncovered for me the last and greatest lesson: souls thriving on failing at bigger and bigger things" (xvii). The heroes of these poems are just such children, transformed by serious illness. For example, Dominic in "Waiting" who "rests on his airbubble cot / awaiting life’s flight from its earthly beat" (10); Ruby in "Ruby Red": "And so poor Ruby meets her final test, in gentle hemolysis rolled to res" (35); the lovely young woman in "Elegy": "You’re newly dead, sans wig, / seventeen year old virgin whom / I’d loved." (57).

"I try through writing poems to lay a finger on the purpose of illness, on its pulse .  . Poems turn denial and withdrawal into compassion--feeling with. They turn fear into mercy--thank you" (xvii). The poet’s eye remains dispassionate, even though his heart may be breaking, as in "Last Rites" (32), in which a dead toddler’s father and his companion "sluice down the flooring with their hoses. After the vomit and blood the water runs clear." He understands the limits of communication about loss, but recognizes, too, that we must make the attempt; and the attempt has meaning in itself: "Afterward the circles of our talk / snap . . . - Within, we write our / separate texts of it. Between, the tension / stands: this no talk could break." ("Circles," p. 87)

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Anna's grandfather, who used to take her for walks in the cornfields and "listen to the corn" with her, dies. Before his death he gave Anna her own kernels to plant when spring came. Anna, mourning her grandfather when spring comes, doesn't want to plant the seeds; she wants to save them. But her mother points out that if she doesn't plant them, she'll never hear the music from them that her grandfather taught her to hear. She tends the corn and listens. It isn't until fall that she hears the song and crackle of the corn she shared with her grandfather. After the harvest she gathers her own seeds to plant in the coming year.

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